Facial emotion recognition deficits, prefrontal cortical dysfunction, and aggressive, antisocial behavior: Is there a relationship?

摘要

Problem. This study examines arguments put forth in the forensic literature that impaired facial emotion processing is associated with antisocial and aggressive behavior in children, and that such impairment is a likely marker for "developmental" psychopathy. True, facial emotion recognition deficits have been identified in antisocial individuals, but children and adults with a variety of neuropsychiatric impairments also demonstrate impaired emotion recognition and there is no indication that such impairment results in aggression, antisocial behavior, or psychopathy. The question therefore arose whether other factors might dispose a child with facial emotion recognition deficits to act in antisocial, aggressive ways. For example, there is growing evidence that prefrontal cortical deficits may not only impair judgment and one's ability to control angry, paranoid, or aggressive reactions, but also compromise emotion processing. Thus, the present study investigated the relationship between facial emotion recognition deficits and aggressive, antisocial behavior, using prefrontal cortical dysfunction as a moderating variable. Method. This study utilized archival data from a neuroimaging/neuropsychological investigation of childhood psychiatric disorders. The sample was 111 clinic-referred children and young adolescents, none of whom were recruited for conduct problems, although many had such behavioral difficulties. Diagnoses included Asperger's syndrome, high-functioning autism, bipolar disorder, and attention deficit-hyperactivity disorder. Participants were administered neuropsychological tests to assess facial emotion recognition and frontal lobe functioning. Outcome measures were parent and teacher ratings on the Child Behavior Checklist. Findings. Facial emotion deficits alone did not predict aggressive or antisocial behavior. Furthermore, prefrontal cortical dysfunction did not predict social maladaptation, nor did the interaction of these neuropsychological variables predict such. Rather, a diagnosis of bipolar disorder was a potent predictor of aggressive and antisocial behavior. Implications. The overlap of signs and symptoms of early onset bipolar disorder and "developmental" psychopathy is substantial and, to date, there has been no research comparing and contrasting the two diagnostic constructs. With the advent of several juvenile psychopathy measures, it is too easy to label an antisocial, callous, aggressive child as "psychopathic" and miss a highly treatable neuropsychiatric condition. Until this issue is carefully investigated, psychopathy checklists should be avoided when evaluating aggressive/antisocial youth.; Key words. facial emotion recognition, prefrontal cortex, aggression, psychopathy, bipolar disorder, conduct disorder